Tuesday, March 5, 2013

INVISIBLE SUFFERING

My new book, The
Bedside Manifesto (to be published within the next month), argues that authentic
healthcare reform won’t result from any juggle of its economics, only from reviving
its center, the venerable “bedside manner.”

I needed to know what other authors were saying, so read
piles of books on the subject, almost all written by physicians. Their titles
include words I, too, use, like Relationship, Caring, Listening, and Compassion.
Yet astonishingly, they’re almost all about diagnosis:
pay better attention to the patient and you’ll diagnose more accurately.

Of course, a proper diagnosis leads to optimum
physical treatment, and who wouldn’t call that a good thing? Yet none of these
good doctors write about patients’ feelings. What’s the shape of their
suffering, regardless of diagnosis? How can they be helped to feel better,
right now, before any medical treatment?

The authors who do address patients’ feelings are
those who work in palliative care. Here, at the apparent end of life, where diagnosis
is no longer paramount, comfort is the priority.

Doctors tend to focus on literature within their own
field, where there’s plenty to keep up on. To them, palliative care can feel outside
mainstream medicine. In fact, end-of-life specialists lament that in the
medical mind, a hospice is only somewhere to go to die. While that’s usually
true, it’s more, too, as it offers long-sought comfort. A friend of mine who
recently engaged hospice services told me, “Finally, no more chemo that makes
me sick. The hospice nurses are interested only in me, not my illness. They
hear me and keep me comfortable and as pain-free as possible.”

I’d love to see the hospice ethic extend into
mainstream medicine. Why shouldn’t every patient with any condition receive
this sort of personal attention and comforting?

6 comments:

Your book sounds wonderful, Jeff! I hope it is widely read and applied.

From what I have seen, there has been a consistent trend of narrowing the type of individuals who are accepted into medical schools. More "mathematicians" and fewer "liberal artists." The result is physicians having the bedside manor of the Data character from Star Trek!

When I entered medical school--I can't believe it--fifty years ago, there were four women in our class of sixty-eight. Now more than half the students are women. That's not because admission committees have changed their ways; its' because women physicians are finally sitting on those committees.

In the same way, schools will opt for humane applicants over impersonal nerds once people like you, Dr. J, occupy committee seats.

It's a wonder that I was admitted. Interested in languages, I was no college scientist. Yet for a couple of years my school decided to choose "well-rounded" students. They reversed that policy after the class following mine organized the county hospital workers and led them out on strike.

About Me

My medical practice consists exclusively of listening to patients and their families. Having limited my focus since the late 1970s to cancer support group facilitation, I founded the support programs at Sutter Cancer Center in Sacramento and Sierra Nevada Cancer Center in Grass Valley, CA.
I’ve published dozens of periodical articles on the healing relationship. My most recent book is How to Heal: A Guide for Caregivers (Helios Press, 2003). I teach medical practitioners “bedside manner” in workshops nationally.